Provider Demographics
NPI:1386244226
Name:KELSEY A RIGOPOULOS
Entity type:Organization
Organization Name:KELSEY A RIGOPOULOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:978-846-6164
Mailing Address - Street 1:418 PATRIOTS RD STE A
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01468-1614
Mailing Address - Country:US
Mailing Address - Phone:978-846-6164
Mailing Address - Fax:978-334-0365
Practice Address - Street 1:418 PATRIOTS RD STE A
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:MA
Practice Address - Zip Code:01468-1614
Practice Address - Country:US
Practice Address - Phone:978-846-6164
Practice Address - Fax:978-334-0365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty